Zusammenfassung
Bei der Erfassung kausaler Faktoren männlicher Fertilitätsstörungen spielen Lebensstil und Umweltfaktoren eine wichtige Rolle. Das Wissen um die Wechselwirkungen zwischen derartigen Einflüssen und reproduktiven Funktionen des Mannes eröffnet zudem die Möglichkeit eines präventiven Ansatzes in der Andrologie. Relevante exogene Noxen sind Genussgifte, Pharmaka einschließlich Lifestyle-Medikamenten, Berufsstoffe, Umweltchemikalien sowie physikalische Faktoren. Reproduktionstoxische Effekte können sich prätestikulär, testikulär oder posttestikulär entfalten und neben einer Beeinträchtigung der Spermatogenese oder Spermienfunktion auch Hormon- und Sexualstörungen verursachen. Aufgrund der komplexen Regulation des männlichen Reproduktionssystems sowie der begrenzten Übertragbarkeit tierexperimenteller Befunde und In-vitro-Daten auf die Situation beim Menschen liegen allerdings nur für wenige Noxen gesicherte Erkenntnisse vor. In der andrologischen Sprechstunde sollten bei Erhebung der Anamnese potenzielle Expositionsrisiken erfasst und die Patienten über eine gesicherte oder mögliche Relevanz für ihre Fertilität aufgeklärt werden.
Abstract
The identification of potential environmental hazards is of clinical relevance for the diagnosis of male infertility. Knowledge about these factors will improve prevention of fertility disorders. Apart from drugs or factors related to lifestyle such as alcohol and tobacco smoke, various environmental and occupational agents, both chemical and physical, may impair male reproduction. Reproductive toxicity may evolve at the hypothalamic–pituitary, testicular, or posttesticular level; endpoints comprise deterioration of spermatogenesis and sperm function as well as endocrine disorders and sexual dysfunction. However, due to the complex regulation of the male reproductive system, information regarding single exogenous factors and their mechanisms of action in humans is limited. This is also due to the fact that extrapolation of results obtained from experimental animal or in vitro studies remains difficult. Nevertheless, the assessment of relevant exposures to reproductive toxicants should be carefully evaluated during diagnostic procedures of andrological patients.
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H.-C. Schuppe und F.-M. Köhn geben an, dass kein Interessenkonflikt besteht.
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Gekürzte und aktualisierte Version der Übersichtsarbeit von Schuppe HC, Köhn FM (2018) Einfluss von Lebensstil und Umweltfaktoren auf die reproduktive Gesundheit des Mannes. Hautarzt 69:996–1005. https://doi.org/10.1007/s00105-018-4307-2.

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Schuppe, HC., Köhn, FM. Umweltfaktoren, Lebensstil und männliche Fertilität. Urologie 61, 1217–1228 (2022). https://doi.org/10.1007/s00120-022-01951-z
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DOI: https://doi.org/10.1007/s00120-022-01951-z